Preliminary Study On Pulmonary Microecology In Patients With Abdominal Sepsis And Acute Respiratory Distress Syndrome

Research background:Sepsis refers to systemic inflammatory response syndrome(SIRS)caused by infection.It is one of the serious complications of infection,trauma,shock and other clinical critical patients.It can induce multiple organ dysfunction syndrome(MODS)and then lead to death of patients.However,the mechanism has not been fully clarified 。 One of the possible pathogenesis of abdominal sepsis is intestinal bacterial/endotoxin translocation.The stress reaction after severe injury can cause the destruction of intestinal mucosal barrier,the imbalance of intestinal flora and the destruction of the body’s immune function,thus causing intestinal bacterial translocation.However,the lung is the most vulnerable organ of enterogenous sepsis,and serious cases can lead to acute lung injury,acute respiratory distress syndrome and other diseases.According to relevant studies,the lung microbiota after sepsis is rich in intestinal bacteria,and it is concluded that the lung microbiota is rich in intestinal bacteria in patients with ARDS.At present,there are few clinical studies on abdominal sepsis complicated with ARDS in China.Therefore,this subject carries out a preliminary analysis of the lung micro-ecology of such patients through the microbiological analysis technology of the patient’s pulmonary alveolar lavage fluid,that is,2bRAD-M technology,and observes the relevant prognosis,and preliminarily discusses the lung injury and changes of the lung micro-ecology of patients with sepsis,thus providing help for the prevention and treatment of lung infection in patients with sepsis.Objective:To study the changes of pulmonary microecology in patients with abdominal sepsis and acute respiratory distress syndrome.Methods:The data of 2021-2022 were collected from the intensive care unit of Qing Dao Municipal Hospital,including acute severe pancreatitis,gastric perforation,colon perforation,incarcerated hernia and other related severe infectious diseases due to abdominal infection.The screening met the requirements(no previous basic lung diseases).The patients in the hospital,after hospitalization,had different degrees of lung infection,including the nature of sputum,temperature changes,related infection indicators,the chest CT results,a total of 11 cases.During hospitalization,bronchoscopy was performed in the intensive care unit,and the patient’s alveolar lavage fluid was taken,and the associated flora of the patient’s alveolar lavage fluid was initially examined and cultured.The 11 patients included were divided into 3 groups according to the recovery of the patients: 4 patients were discharged after treatment in group A,3 patients were discharged after giving up treatment in group B,and 4 patients died in group C.The samples were further gene tested by 2bRAD-M microbial diversity analysis technology.At the same time,it is compared with the 2bRAD database.Result:1.In the culture of peritoneal drainage fluid collected from 11 patients with abdominal sepsis,G-bacteria accounted for 72.72%,G+bacteria accounted for 9.09%,and 1 case with mixed infection of G+and G-bacteria was detected accounting for 9.09%.2.The positive rate of peritoneal drainage culture was 90.90%,the positive rate of hospital bronchial culture was 45.45%,and the positive rate of 2bRAD-M technology was100%.The similarity of culture results was low.3.Among the three groups of patients,the lung micro-ecological abundance of patients in Group C was significantly reduced,all of them were death cases.Conclusion:1.The abdominal cavity of patients with abdominal sepsis is mainly infected by G-bacteria,and some may be accompanied by G+bacteria infection,which can provide suggestions for the initial treatment of patients.2.The pulmonary micro-ecology of patients with abdominal sepsis has changed,but the pulmonary infection is also related to abdominal infection,secondary infection in hospital and other factors.The composition of celiac flora and pulmonary flora are both similar and different.3.The lower the abundance of pulmonary flora,the worse the prognosis.